The majority of cases of non-small cell lung cancer (NSCLC) are diagnosed in older patients, and it is not uncommon to encounter patients over the age of 90. However, information on treatment patterns in patients 90 years of age and older are lacking due to a paucity of studies in this population. A study published this month sought to clarify treatment patterns and outcomes in 7205 patients with NSCLC who were older than 90 years of age. The study used patient records from the National Cancer Database records for patients treated between 2004 and 2014.
The study found that more than half of patients (57.6%) over the age of 90 did not receive treatment for their NSCLC. Those who did receive treatment had significantly improved 5-year overall survival (OS) compared to those who did not receive treatment (9.3% vs 1.7%; HR 0.53, P<.001). The greatest survival benefit for curative-intent treatment versus nontreatment was seen in patients with stage I disease (median OS 27.4 months vs 10.0 months; P<.001). Curative-intent treatment was also associated with an improvement in OS compared to nontreatment in patients with stage II (12.8 months vs 4.5 months), stage III (11.6 months vs 2.3 months), and stage IV disease (4.4 months vs 1.5 months), though the magnitude of this benefit was reduced in patients with advanced stage disease. Patients with surgically resectable disease had best outcomes of all patients. Among stage I patients who received treatment, surgery was associated with superior 5-year OS compared to nonoperative therapy (33.7% vs 17.1%).
The investigators concluded that treatment is associated with a significant and clinically meaningful survival benefit for patients with NSCLC who are over 90 years of age, particularly in patients with stage I disease. This highlights that age should not be the only factor influencing decisions of when to treat in elderly patients, and that patient preference and disease stage should also have a major influence.
For more information about this study, visit Medscape Medical News.